Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $42.86 / $418.50	Facility		$12.30	$42.86	$418.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $98.22 / $146.33 / $261.00	Facility	25	$98.22	$146.33	$261.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.23 / $23.07 / $69.75	Professional		$8.23	$23.07	$69.75
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $17.17 / $32.04 / $78.97	Professional	25	$17.17	$32.04	$78.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $10.73 / $24.53 / $51.38	Professional		$10.73	$24.53	$51.38
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $20.59 / $23.39 / $50.00	Professional	25	$20.59	$23.39	$50.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.12 / $12.90 / $14.61	Facility		$11.12	$12.90	$14.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $23.51 / $47.72	Professional		$11.12	$23.51	$47.72
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $88.30 / $115.00 / $139.00	Facility		$88.30	$115.00	$139.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.61 / $29.12 / $68.30	Professional		$19.61	$29.12	$68.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.10 / $150.00 / $180.00	Facility		$30.10	$150.00	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.35 / $22.16 / $47.22	Professional		$9.35	$22.16	$47.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $9.69 / $13.08 / $35.86	Professional		$9.69	$13.08	$35.86
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $21.94 / $21.94	Professional		$21.94	$21.94	$21.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $8.67 / $23.13 / $45.48	Professional		$8.67	$23.13	$45.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $42.70 / $42.70 / $50.00	Facility		$42.70	$42.70	$50.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $86.77 / $220.00 / $489.00	Professional		$86.77	$220.00	$489.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $32.34 / $32.34	Professional		$32.15	$32.34	$32.34
Optum Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $27.70 / $66.14	Professional		$22.95	$27.70	$66.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.84 / $20.16 / $36.25	Facility		$8.84	$20.16	$36.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $9.80 / $23.54 / $55.43	Professional		$9.80	$23.54	$55.43
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $40.00 / $74.00	Facility		$35.00	$40.00	$74.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $27.78 / $66.14	Professional		$23.38	$27.78	$66.14
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $12.00 / $33.22	Professional		$7.83	$12.00	$33.22
United Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $49.00 / $49.00	Facility		$49.00	$49.00	$49.00
United Facility/Professional Professional Modifier Low / Median / High Price $16.41 / $22.75 / $56.79	Professional		$16.41	$22.75	$56.79